In any number of accidents, illnesses, and injuries, the emergency care you receive can have a tremendous impact on your outcome. Paramedics must respond to the situation, provide life-saving medical attention, and decide where to take you for treatment. For patients who call 911 with chest pain, this decision can be particularly difficult.
First, paramedics must identify the 7% of callers who are experiencing a heart attack. Once they rule out a heart attack, they should work to identify the additional 20% who need specific cardiac care. If paramedics complete this process correctly, they can take patients to the correct facility, helping ensure patients receive the care they need right away instead of being transported from their original destinations to facilities that have interventional cardiology capabilities.
Studying a New and Improved Approach
In a study conducted at Wake Forest Baptist Health, researchers showed that “on-scene use of a new protocol and advanced diagnostic equipment can help paramedics better identify patients at high risk for adverse cardiac events.”
Previously, paramedics used a portable electrocardiogram (EKG) to look for signs of a heart attack before using their experience and patient preference to choose a treatment location. In the study, the research team trained more than 150 paramedics on the HEART Pathway program, which has been used in emergency departments for 8 years. In this program, paramedics ask patients questions about their chest pain, age, risk factors, and medical history – and use a handheld i-STAT device to measure levels of troponin (a heart enzyme) in the blood and detect heart injury.
By ruling out not only heart attack but also heart injuries, paramedics can get individuals who may be at risk for adverse cardiac events the care they need. Using the HEART Pathway program, paramedics were better able to predict whether patients would experience adverse cardiac events, allowing them to receive the correct treatment. For those with high-risk of adverse cardiac events, paramedics were able to anticipate the events 61% of the time and choose the right facility 96% of the time, and for patients with low-risk, paramedic predictions were correct 94% of the time.
According to the researchers:
“This teamwork between emergency medicine researchers and our local EMS agencies is so valuable. Our study showed that paramedics have the professional clinical ability to effectively assess patients’ cardiac risk using this protocol before the patient ever gets to the hospital. We hope this approach will allow patients to receive faster, more focused care.”
Our Hopes for a New Standard of Care
While the HEART Pathway program is still more popular in emergency rooms than ambulances, we think it’s wonderful that paramedics can better identify patients who are at risk for adverse cardiac events and use this information to save lives. We hope this program in North Carolina influences emergency care across the nation.
Someday, we hope to see the HEART Pathway program become the standard of care. Getting individuals with heart injuries the care they need is crucial, and every medical provider should have the tools they need to do so.
All too often, substandard medical care leads to injuries and deaths that never should have happened.
While treatment is improving across North Carolina and we are pleased to celebrate it, we also want to remind you that you can call the attorneys at Kahn Law Firm, LLP are here for you when you have concerns about your care.